| NPI | 1477852374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH022005) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302034036) |
| 183500000X Pharmacist (Licence: MD 16883) | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-03-18 |